LOLA
06-15-2010, 07:51 PM
من مذكرات ستاجي حالات بفكر اني ما كنت رح صادفها أبدا بحياتي ....
ذكر العمر 60 سنة
الشكوى الرئيسية :
المريض غير قادرعلى فتح عينيه
صعوبة كلام و بلع
تعب عام في الجسم بعد الجهد دون ألم
MYASTHENIA GRAVIS (file:///D:/Dr%20Bashar/med/Physical%20Examination/5-Minute%20clinical%20consult/Medic/M/DocumentBodyContent.aspx-DocId=700&FxId=31&SessionId=A0682AUTDXUOSSGK&Scroll=1.htm)
Most common primary disorder of the neuromuscular junction, resulting in a pure motor syndrome characterized by fluctuating skeletal muscle weakness, particularly of the extraocular, pharyngeal, facial, and respiratory musculature.
clinical forms:
1-Generalized MG (85%): Commonly affects ocular as well as a variable combination of bulbar, proximal limb, and respiratory muscles
2-Ocular MG (15%): Weakness limited to eyelids and extraocular muscles
Onset is typically mild and intermittent over many years but it
may be sudden and severe
ETIOLOGY
Antibodies to acetylcholine receptor protein (anti-AChR antibodies) are commonly found.
They attack the postsynaptic membrane of the neuromuscular junction.
Female >male (2:1)
SIGNS AND SYMPTOMS
1) Ptosis
2) Diplopia
3) Dysphagia
4) Dysarthria
5) Fatigable chewing
6) Facial weakness
7) Dysphonia
8) Neck weakness
9) Proximal limb weakness (arm > leg)
10) Respiratory weakness
RISK FACTORS
file:///C:/Users/moutaz/AppData/Local/Temp/msohtmlclip1/01/clip_image001.gif Familial MG
file:///C:/Users/moutaz/AppData/Local/Temp/msohtmlclip1/01/clip_image001.gif Other autoimmune diseases
TESTS:
Bedside tests:Tensilon (Edrophonium) test:
Electromyography
Lab:
Acetylcholine receptor (AChR) antibody
Thyroid function tests
CT or MRI scan of anterior mediastinum
Treatment :
Oral anticholinesterases
Immunosuppressant drugs
Thymectomy
……………………………………………………………………………………………………………….
Kumar and Clark's clinical medicine
Stedman
THE 5-MINUTE CLINICAL CONSULT 2008 - 16th Ed.
ذكر العمر 60 سنة
الشكوى الرئيسية :
المريض غير قادرعلى فتح عينيه
صعوبة كلام و بلع
تعب عام في الجسم بعد الجهد دون ألم
MYASTHENIA GRAVIS (file:///D:/Dr%20Bashar/med/Physical%20Examination/5-Minute%20clinical%20consult/Medic/M/DocumentBodyContent.aspx-DocId=700&FxId=31&SessionId=A0682AUTDXUOSSGK&Scroll=1.htm)
Most common primary disorder of the neuromuscular junction, resulting in a pure motor syndrome characterized by fluctuating skeletal muscle weakness, particularly of the extraocular, pharyngeal, facial, and respiratory musculature.
clinical forms:
1-Generalized MG (85%): Commonly affects ocular as well as a variable combination of bulbar, proximal limb, and respiratory muscles
2-Ocular MG (15%): Weakness limited to eyelids and extraocular muscles
Onset is typically mild and intermittent over many years but it
may be sudden and severe
ETIOLOGY
Antibodies to acetylcholine receptor protein (anti-AChR antibodies) are commonly found.
They attack the postsynaptic membrane of the neuromuscular junction.
Female >male (2:1)
SIGNS AND SYMPTOMS
1) Ptosis
2) Diplopia
3) Dysphagia
4) Dysarthria
5) Fatigable chewing
6) Facial weakness
7) Dysphonia
8) Neck weakness
9) Proximal limb weakness (arm > leg)
10) Respiratory weakness
RISK FACTORS
file:///C:/Users/moutaz/AppData/Local/Temp/msohtmlclip1/01/clip_image001.gif Familial MG
file:///C:/Users/moutaz/AppData/Local/Temp/msohtmlclip1/01/clip_image001.gif Other autoimmune diseases
TESTS:
Bedside tests:Tensilon (Edrophonium) test:
Electromyography
Lab:
Acetylcholine receptor (AChR) antibody
Thyroid function tests
CT or MRI scan of anterior mediastinum
Treatment :
Oral anticholinesterases
Immunosuppressant drugs
Thymectomy
……………………………………………………………………………………………………………….
Kumar and Clark's clinical medicine
Stedman
THE 5-MINUTE CLINICAL CONSULT 2008 - 16th Ed.